Immune and related inflammatory diseases are a manifestation of complex, frequently interconnected biological pathways which in normal physiology respond to insult or injury by initiating repair of the insult or injury, and mount an innate and acquired response. Disease or pathology occurs when these physiological pathways cause further insult or injury, either by an exaggerated response caused by an abnormal regulation or overstimulation, or a combination of the two. Despite the advent of new anti-inflammatory drugs such as anti-TNF agents, inflammatory diseases continue to represent an important unmet medical need, often due to a lack of responsiveness and resistance to these drugs.
Immune and related inflammatory diseases that may be modulated by the use of anti-inflammatory agents include Autoimmune Diabetes (any others similar), diabetes mellitus, uveitis, (1) Multiple Sclerosis, Rheumatoid Arthritis (RA), Irritable Bowel Disease (IBD), Irritable Bowel syndrome, ulcerative colitis, Crohn's disease, Controlling Allograft Rejection after organ transplantation, graft versus host disease (GVHD), inflammatory lung diseases including asthma and chronic obstructive pulmonary disease (COPD) (2), cancer (4) systemic lupus erythematosus, SLE, sarcoidosis, cancer and Psoriasis.
RA is considered a systemic autoimmune disease, managed by treatment with Disease-modifying anti-rheumatic drugs (DMARDS), typically in combination, to minimize the side effects associated with systemic drugs. Side effects of these drugs include ulcerative stomatitis, reduced white blood count
IBD is a term that describes chronic inflammation disorder of the small and/or large intestine. Included within the area of IBD is ulcerative colitis and Crohn's disease. While the exact causes are not firmly established, IBD is considered to be an autoimmune disease. Currently no cure is available, and treatments are focused on suppressing the abnormal or exaggerated inflammatory response. Treatments include corticosteroids (such as methotrexate, azathioprine, and mercaptopurine) and aminosalicylates. Long term use of corticosteroids are associated with thinning of the bones, infection, cataracts, and love and bone marrow effects. Aminosalicylates tend to be better tolerated, since they are poorly absorbed, and act on the affected area topically. Side effects include headache, and rarely more serious conditions, such as pancreatitis.
Psoriasis is treated in different ways. Use of corticosteroids topically is a common method of treatment, but drawbacks include ineffectiveness and development of resistance. Use of phototherapy is effective in treating psoriasis by increasing apoptosis, implicated in reduced inflammation. Short term drawbacks are increased discomfort, and itching, with long term effects being an increased risk of squamous cell and melanoma skin cancers. Systemic drugs are utilised to treat psoriasis, which have a variety of other, often undesired systemic effects and must be used under close supervision and monitoring by a dermatologist.
Therefore there is still a need to design new treatments for an inflammatory disease such as RA, IBD, and psoriasis which do not have all the drawbacks of existing treatments.